As a doctor, how do I determine when I am financially prepared for retirement?

Estimate Current Cash Flow

Whether you’ve been considering retiring from medicine for some time or the idea only occurred to you recently, you may be ready to make it happen – but are your finances ready? Start with cash flow.

It’s important to estimate what your current cash flow needs are to determine, based on your life expectancy, how many years your retirement ‘nest egg’ will last. Look at everyday expenses (mortgage payments, child expenses/schooling, auto expenses, food and other household expenses), and determine the annual cost of retirement hobbies (golfing, travelling, etc.) and other foreseeable expenditures (vacation home, children’s weddings, etc.), comparing these expenditures with the amount of income your investments will earn once you have retired. The difference will have to come out of your retirement nest egg and will, in turn, reduce the amount of income your investments will generate each year.

Review your sources of income such as CPP, pension payments from an IPP, investment assets and the tax effectiveness of each type of income. Calculate whether your after-tax income will cover your expenses. Track your expenses so that you can make changes if your income isn’t high enough to pay for everything.

Pension and interest income are taxed at your highest marginal tax rate. Dividends and capital gains are taxed at a lower rate. So you should try to structure your investment portfolio so that interest income is earned in a registered account such as an RRSP, RRIF or TFSA.

Splitting Income

CPP and pension income can be split with your spouse so that you end up paying less tax. When you apply for your CPP, you will have to indicate the desire to split the income with your spouse on the application form. If you are receiving income from a pension or a Registered Retirement Income Fund (RRIF), you can choose the most tax-effective split with your spouse when you file your tax return. When you calculate the best allocation, keep in mind the clawback on Old Age Security (OAS) — which is based on your income — so that you don’t end up losing your OAS entitlement.

Risk and Your Asset Mix

Review your investment portfolio’s asset mix and make sure it matches your risk profile. Now that you are retiring, you may want to take on less risk. In that case, you may want to reduce your exposure to equities and increase your exposure to cash and fixed income such as bonds and GICs. Keep in mind that if you do this, your portfolio’s rate of return will probably decrease. Review your cash flow requirements before making this change.

Which assets do you draw down first?

Which pool of retirement assets do you start to draw down first — TFSA, non-registered account, RRSP/RRIF, money in your professional corporation, etc.? The answer to this question depends on your age and the age of your spouse; whether the investments in those accounts have unrealized accrued gains; how much income is required and how the income will be taxed once the amounts are distributed from the investment account. There is no one right answer and often monies are taken annually from a combination of sources.

Closing a medical practice is a complex undertaking and requires a carefully planned strategy.

Here are 8 tips to remember when closing your practice*:

1. Inform your staff three months in advance of the anticipated closing date.

2. Make sure to outline a staff severance policy and take care to meet your obligations to pay any unused benefits such as sick time and vacation.

3. Inform each high-risk patient suffering from a chronic or complicated medical condition to secure a new doctor, given his/her medical condition requires ongoing attention.

4. Send each high-risk patient a follow-up letter summarizing the discussion and the need to retain the services of another physician immediately.

5. Determine the need to transfer the care of compromised patients.

6. Make referrals, where appropriate.

7. Three months prior to closing, notify patients.

8. Secure and protect the confidentiality of the records you retain. Storage options include archiving records, contracting with a storage firm, or scanning into a read-only digital media.

Since 1997, RSRS has assisted hundreds of physicians with their medical practice closures and record-storage obligations. Whether you’re retiring, relocating or enquiring on behalf of a doctor’s estate, RSRS can help. RSRS is the only physician-managed, fully compliant storage facility in Canada and follows the guidelines for each Canadian province with respect to medical practice closure and patient record retention.

Life is all about new beginnings and new directions, so if you’ve been thinking about transitioning out of medicine into a second career before you retire, there may be no better time than the present to do so.

Everyone has hidden talents and a secret career that they’ve always dreamed about. There’s so much choice, that the paths to finding your bliss are virtually limitless.

Looking to channel your inner Iron Chef? Then why not launch that food truck you’ve been putting together in your head these last few years? Tricked-out trucks are all the rage and regularly attract lineups of famished foodies eager to sample exotic fare.

What excites you now? Is it time to follow a new passion?

Moroccan tacos? Vietnamese noodle soups? Israeli/Mediterranean tapas? The menu is limited only by your imagination. Buy a truck, finalize a culinary theme, think up a clever name and you’re good to go.

You could start a catering company or launch a baked-goods business.

Fancy yourself the host with the most? Then why not open a bed and breakfast in the country (or city, for that matter)? We know of a couple of retired physicians who have done just that. Opportunities abound online — everything from freelance writing and craft-related businesses to consulting.

Now may be the ideal time to turn your untapped skills into gold and pursue a second career that will reignite your passion.

Seize the day. Your future starts now.

If concern for your patients is preventing you from transitioning out of medicine, don’t give it a second thought, because RSRS will make sure the transition goes super-smoothly.

Since 1997, RSRS has helped more than 1,000 physicians to properly notify patients, transfer their patient records and meet their record-storage obligations. Where possible, RSRS even helps patients find a new doctor.

With RSRS, your patients’ needs are our highest priority.

RSRS is the only physician-managed, fully compliant storage facility in Canada. RSRS follows provincial guidelines for medical practice closure and patient record retention.

Retirement is the reward for a lifetime of hard work and sacrifice. You’ve earned the right to hang up your stethoscope and enjoy the good life: travel, golf, pursue a favourite hobby or take up a new one, whatever turns your crank.

Not surprisingly, more than 75% of all retirees report retirement satisfaction. But for those that struggle with retirement, adjusting to a life without work can pose challenges, everything from emotional and physical problems, to drug and alcohol addiction, to financial-planning issues. Even among doctors, this is not uncommon, nor should you feel that you have to go it alone.

Dr. Roadburg’s book gathers the experiences and advice of 300 retired physicians.

If you’re retired, or you’re planning to retire and you are not feeling quite right about things, you should know that help is at hand. There are a variety of services, and even a book, available for your assistance and reassurance.

For example, the Canadian Medical Association (CMA) offers, for its members, ePhysicianHealth.com, an online health and wellness resource designed to help doctors in their personal lives.

The site offers a constantly expanding menu of modules, each addressing an issue — for example, Anxiety; Depression, Burnout and Suicide; Substance Abuse Disorders; and Weight, Nutrition and Fitness — and each authored by a leading expert in physician health.

Each module introduces the topic; highlights the relevance of the topic to doctors; provides resources for dealing with the topic; and outlines next steps. Each module can be downloaded as a printable e-book.

In addition, the CMA provides a wealth and practice management service through its company, MD Physician Services.

Beyond that, a number of provincial medical associations offer programs that address subjects relevant to retired or soon-to-retire member doctors.

For example, the New Brunswick Medical Society offers an advocacy service for physicians featuring a 24-hour confidential hotline and helps identify those needing assistance, intervention and follow-up services. It also arranges referrals.

The Newfoundland and Labrador Medical Association (NLMA) offers confidential professional counselling and information services for all NLMA members through its inConfidence program. Work/life consultants are also available to offer support with a wide variety of issues.

NLMA also offers MDLink, a program that connects physician-patients with physician-providers.

At Doctors Nova Scotia, the Professional Support Program’s physician coordinators assess each doctor’s issues and, depending on the problem, can provide counselling or make a referral to the appropriate service, doctor or resource. There’s also a Business of Medicine Program designed to take the guesswork out of running a practice.

Alberta doctors can address mental health and family issues through the Alberta Medical Association’s Physician and Family Support Program (PFSP). The program offers general counselling and, on request, can provide education sessions about career transitions and retirement. Moreover, the PFSP can integrate medical treatment to address physical or mental illness.

In Saskatchewan, the provincial medical association’s Physician Health Program offers confidential referral, intervention and on-going support to physicians and their families. Consultation and advice are also available to doctors handling difficult interpersonal issues.

To dig deeper still, pick up a copy of Life After Medicine — Retirement Lifestyle Readiness. Written by Toronto-based author Alan Roadburg, PhD, the book features insights collected from research conducted among 300 retired physicians in the U.S. and Canada, including 180 retired OMA doctors. The book, which also offers Life Goal Planning self-help exercises, costs around $18 and is available online at Amazon and Chapters.

Since 1997, RSRS — the only physician-managed, fully compliant storage facility in Canada — has assisted hundreds of doctors with their medical practice closures and record storage obligations.

We offer a complete medical practice closure consulting service, and in most cases for Ontario Primary Care Doctors, we can offer full record scanning and storage services and more, at NO CHARGE.

Telemedicine couldn’t be more convenient, since it can be done part-time or full-time, from home.

And with so many ongoing technological advancements, telemedicine is easier than ever. All it takes is a telephone and a reliable Internet connection.

Telemedicine opportunities abound — for example, in remote and under populated areas, where climate and geography pose challenges. In Ontario, the Thunder Bay Regional Health Sciences Centre’s telemedicine site is one of Canada’s busiest.

How long can – or should – doctors practice before hanging up their stethoscope? It’s a delicate issue, fraught with issues such as the difficulty of accepting the idea of aging and the ingrained notion that retirement represents the end of a productive life.

But there’s a lot at stake. Physicians who continue practicing beyond a certain point will jeopardize patients’ lives.

It’s inevitable that clinical analysis, advanced mental functions, memory and the capacity to learn decline with age, a fact backed up by a number of studies.

Even the desire to learn can decline with age. There’s evidence that doctors who pursue continuing education keep their practice at a high level. Yet at least one study reveals that as doctors age, they’re less likely to participate in continuing education — professional suicide in a profession where the landscape is changing at warp speed.

Doctors need to be honest with themselves and know when to retire before health or competency issues force them to get out of the game. And in that scenario, no one — not the physician, not their patients and certainly not the healthcare system — wins.

Since 1997, RSRS — the only physician-managed, fully compliant storage facility in Canada — has assisted hundreds of doctors with their medical practice closures and record storage obligations.

RSRS offers a complete medical practice closure consulting service, and for Primary Care Doctors, RSRS can usually offer medical practice closure and patient record retention services at NO CHARGE.

When a doctor has hired a service provider to manage the storage of their clinical files, the physician is still responsible for maintaining security according to privacy legislation and College requirements, notes the CMPA.

If a commercial provider stores the records, some Canadian jurisdictions have health-specific privacy laws requiring doctors to sign a written agreement with the provider. And even if it’s not required, it’s still a good idea.

Most colleges require that physicians inform their patients as to where their records are stored and how they may be accessed.

For paper records, shredding and pulverization are effective. Incineration is no longer acceptable for environmental reasons. To ensure security, effectiveness and compliance, it is recommended that a professional company manage the destruction of medical records. In the case of electronic records, permanent deletion or irreversible erasure are good bets. Doctors must consider whether it’s necessary to destroy the original along with copies and back-up files.

Since 1997, RSRS has assisted hundreds of physicians with their record storage obligations. RSRS is the only physician-managed, fully compliant storage facility in Canada and follows the guidelines for each Canadian province with respect to patient record retention.

Not only would the destroyed files compromise patient healthcare, but the files themselves, if they were sitting in, or exposed to, sewage-contaminated water, posed a potential health hazard to doctors and those assisting them.

In fact, the College of Physicians & Surgeons of Alberta cautioned doctors to treat all damaged files as hazardous materials and advised them to wear N95 masks, goggles, protective clothing and gloves while handling them.

Furthermore, the College advised doctors to determine whether their files were recoverable or needed to be destroyed, and to arrange safe storage of recoverable files or safe destruction of unrecoverable files through processes that “maintain the confidentiality of file content.”

If doctors decided to destroy patient records, they had to document their rationale for doing so, by taking photographs of the file room and “representative sections of shelves to illustrate the condition of the files.”

What a mess — in every sense of the word.

And the sad fact is, in many cases such losses are completely preventable.

Where are all the doctors? It’s a crucial question, since these days, physician shortages are widespread — and not without consequences.

In Bonnyville, Alta., for instance, Alberta Health Services (AHS) decided to close the hospital’s two-person pathology department rather than replace one of the retiring specialists.

According to media reports, AHS thought it would be too difficult to find a replacement pathologist and believed that a one-person department couldn’t handle the workload.

This will force the hospital to send biopsies to Edmonton, resulting in a two- to four-week wait for results, compared to the one to five days with the onsite pathologists.

Moreover, it will be difficult for the hospital’s medical staff to consult with pathologists about which lab tests to order or to discuss test results.

The closure of Bonnyville’s pathology department will likely affect patients. Similarly, closing a practice can have a significant impact on your patients.

Since 1997, RSRS has helped hundreds of doctors with medical-practice closures and record-storage obligations, minimizing the negative effects of practice closure on everyone affected. Whether you’re retiring, relocating or enquiring on behalf of a doctor’s estate, RSRS can help.

RSRS is the only physician-managed, fully compliant storage facility in Canada and follows the guidelines for each Canadian province with respect to medical practice closure and patient record retention.

RSRS offers free services for a full-time primary care physician in Ontario, where RSRS is appointed custodian for the records, and facilitates all patient record transfer requests. RSRS also offers excellent rates for primary care physicians and specialists from all other provinces.

The hard truth is, declining physical and cognitive skills are an inevitable part of aging, so it’s crucial to hang up your stethoscope at the proper time, before competency or health issues force you to do so.

Study: a majority of retired doctors experienced better relationships with their spouses.

Plus, there’s evidence that doctors thrive in retirement. One 2003 U.S. study of 1,834 retired physicians and their spouses found that 88 per cent were content. Another U.S. study, published in 2001, reported that a majority of retired doctors experienced better relationships with their spouses.

So how to retire? For family physicians, changing to a more focused practice makes terrific sense. By narrowing their practice to concentrate only on their areas of expertise, older family doctors reduce their workload and ensure they continue to deliver quality care.

Aging family physicians who maintain a full workload invite increased scrutiny by medical regulating bodies — and risk being disciplined or even stripped of their license if their level of patient care slips.

And where’s the dignity in that?

Since 1997, RSRS — the only physician-managed, fully compliant storage facility in Canada — has assisted hundreds of doctors with their medical practice closures and record storage obligations.

We offer a complete medical practice closure consulting service, and in most cases for Ontario Primary Care Doctors, we can offer full record scanning and storage services and more, at NO CHARGE.